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75 years of cancer care: a look back

This year the London Regional Cancer Program (LRCP) at London Health Sciences Centre is celebrating its 75th anniversary.

The Ontario Institute of Radiotherapy, as it was first called, opened on South Street at Victoria Hospital in 1941.

For years the hospital had already been treating cancer patients. A report shows that in 1936, 86 cancer patients were treated.

Fast forward to 2016 and our latest data shows that the LRCP treated more than 15,000 patients across Southwestern Ontario.

In the intervening years the LRCP has built a rich history of care.

“When I think about the anniversary of our cancer program in London, I can't help but connect the amazing innovations that we have discovered with the compassionate care that we provide. Over these 75 years, the staff and physicians have positively impacted the lives of hundreds of thousands of people in our region. It's not only about the outstanding discoveries, it's the approach of our teams to offer healing and hope. I see it every day I walk through our centre as our staff and physicians offer the care, the touch, the encouragement, and compassion,” says Neil Johnson, Vice President, Cancer Care and Corporate Strategy.

The first 25 years

After officially opening its doors, the Ontario Institute of Radiotherapy was on its way to world renown just a few years later.

In 1951 the London cancer program was the world’s first to treat a patient with Cobalt 60 radiation. This marked an important milestone for both the fight against cancer and Canada’s emergence as a leader in the field of radiotherapy. Dr. Ivan Smith and Mr. Roy Errington from Eldorado Mining and Refining Ltd, collaborated to develop the machine known as the “Cobalt Bomb.” Its technical name was the Eldorado A, and was used to treat 16 new patients per month.

“Since its inception, approximately 35 million cancer patients worldwide have benefitted from this groundbreaking technology first applied here. London and Canada can take pride in the continuum of bench-to-industry-to-bedside research. It serves as an outstanding illustration of patient-oriented research,” says Dr. Jerry Battista, Director of Physics Research & Education, London Regional Cancer Program.

It was 1956 when the vinblastine chemotherapy drug found in the periwinkle plant was discovered cooperatively with Western University researchers. It would be a few years yet before chemotherapy was introduced for treatment.

The first cancer patient was welcomed at the newly opened Thameswood Lodge in 1962, which provided accommodation for patients in the region coming to London for treatment.

The middle years

In the 1970s chemotherapy treatment was introduced. Temporary quarters were built to provide new library and research laboratory space, primarily for tissue culture research. The first researcher was appointed.

The mid 1980s marked several provincial innovations as the first palliative care program, the first social work department, the first dietician, and the first community cancer outreach program were all established at the cancer centre.

The cancer centre was the first Canadian site to treat malignant melanoma and kidney cancer with Interleukin-2 (IL-2). IL-2 stimulates the growth and activity of certain immune cells that recognize and destroy cancer cells.

In 1988 the cancer program moved to its current Commissioners Road facility with the latest treatment equipment and additional space for research labs.

The world’s first Ytterbium-169 radioactive source brachytherapy treatment was performed here in 1990. In brachytherapy, the radioactive substance is placed directly into, or very close to, the tumour.

The last 25 years

In 2001, the last Cobalt treatment unit was de-commissioned. It was replaced by a tomotherapy unit – the most advanced technology at that time for image-guided placement of radiation beams. With tomotherapy a narrow fan beam is able to target treatment sites visualized in 3D. At the time, this was one of only three cancer treatment centres in Canada, 12 units world-wide, with tomotherapy capability. London was a leader in the scientific and clinical evaluation of this emergent technology.

Physicians continue to use treatment machines with CT image guidance and higher intensity (such as Varian’s TrueBeam) to more precisely aim radiation at tumours such as lung tumours which move as the patient breathes. The treatment is customized to the patient and irradiation only “fires” when the target is at a precise pre-determined location.

Looking ahead

Technological innovations have also advanced the practice of surgical oncology with the introduction of key hole or laparoscopic cancer surgeries. London has been on the forefront of the use of robot assisted laparoscopic surgical techniques, including conducting an important randomized trial of this technology for treating head and neck compared to standard treatment with chemotherapy and radiation.

In the area of systemic or drug treatment of cancer, the evaluation of new drugs and drug combinations alone or in combination with surgery and radiation through rigorously conducted clinical trials has advanced our knowledge of how to best utilize these treatments.

With the sequencing of the human genome, incorporation of molecular information into the design, selection and dosing of existing and novel drugs has created the field of “precision medicine” mirroring the technological innovations in surgery and radiation.

In London we have been pioneers in the area of pharmacogenomics – tailoring the dose of chemotherapy drugs to the genetic and metabolic profile of the patient.

Physicians, researchers and staff affiliated with the cancer centre continue in the strong tradition of innovation as they explore the nature of cancers, the use of personalized medicine in treatment, and the advancement of radiation therapy technology.